Anticardiolipin Testing

  • S. S. Pierangeli
  • A. E. Gharavi
  • E. N. Harris


Anticardiolipin antibody (aCL) tests are important to aid the physician in diagnosis of antiphospholipid syndrome (APS) [1]. Patients affected with APS are subject to episodes of thrombosis in arteries and/or veins, pregnancy loss (probably secondary to thrombosis of vessels in the placenta), and thrombocytopenia, associated with antiphospholipid (aPL) antibodies [1, 2]. aPL antibodies are autoantibodies directed against anionic phospholipids or protein-phospholipid complexes [3–5], measured by solid-phase immunoassays as anticardiolipin (aCL) [6], or as an activity which prolongs phospholipid-dependent coagulation assays, the so-called lupus anticoagulants (LA) [7].


Lupus Anticoagulant Anticardiolipin Antibody Lupus Anticoagulant Anti Phospholipid Syndrome Hughes Syndrome 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Harris EN. Antiphospholipid syndrome. In: Klippel JH, Dieppe PA, editors Rheumatology. London: Mosby-Year Book, 1994;Section 6,32. 1–32. 6.Google Scholar
  2. 2.
    Harris EN, Gharavi AE, Hughes GRV. Antiphospholipid antibodies. Clin Rheum Dis 1985; 11: 591–601.PubMedGoogle Scholar
  3. 3.
    Pierangeli SS, Davis SA, Harris EN and DeLorenzo G. ßZ-glycoprotein 1 (ß2GP1) enhances cardiolipin binding activity but it is not the target antigen for antiphospholipid antibodies. Br J Haematol 1992; 82: 565–570.PubMedCrossRefGoogle Scholar
  4. 4.
    McNeil HP, Simpson RJ, Chesterman CN, Krilis SA. Anti-phospholipid antibodies are directed against a complex antigen that includes a lipid-binding inhibitor of coagulation: f2glycoprotein I. Proc Natl Acad Sci USA 1990; 87: 4120–4124.PubMedCrossRefGoogle Scholar
  5. 5.
    Roubey RA. Autoantibodies to phospholipid binding-plasma proteins: a new view of lupus anticoagulants and other “antiphospholipid” autoantibodies. Blood 1994; 84: 2854–2867.PubMedGoogle Scholar
  6. 6.
    Harris EN, Gharavi AE, Boey ML, Mackworth-Young CG, Loizou S, Hughes GR. Anticardiolipin antibodies: detection by radioimmunoassay and association with thrombosis. Lancet 1983;ii:1211–1214.Google Scholar
  7. 7.
    Triplett DA, Brandt JT. Lupus anticoagulants: misnomer, paradox, riddle, epiphenomenon. Hematol Pathol 1988; 2: 121–143.PubMedGoogle Scholar
  8. 8.
    Harris EN, Gharavi AE, Wasley GD, Hughes GRV. Use of an enzyme-linked immunosorbent assay and of inhibition studies to distinguish between antibodies to cardiolipin from patients with syphilis or autoimmune disorders. J Infect Dis 1988; 157: 23–31.PubMedCrossRefGoogle Scholar
  9. 9.
    Moritsen S, Hoier-Madsen M, Wiik A, Orum O, Strandberg-Pedersen N. The specificity of anticardiolipin antibodies from syphilis patients and from patients with systemic lupus erythematosus. Clin Exp Immunol 1989; 76: 178–183.Google Scholar
  10. 10.
    Galvez J, Martin I, Medino D, Pujol E. Thrombophlebitis in a patient with abute Q fever and anticardiolipin antibodies. Med Clin (Barc) 1997; 15; 108: 396–397.Google Scholar
  11. 11.
    Intrator L, Oksenhendler E, Desforges L, PB. Anticardiolipin antibodies in HIV infected patients with or without autoimmune thrombocytopenia purpura. Br J Haematol 1988; 67: 269–270.CrossRefGoogle Scholar
  12. 12.
    Canoso RT, Zon LI, Groopman JE. Anticardiolipin antibodies associated with HTLV-III infection. Br J Haematol 1987; 65: 495–498.PubMedCrossRefGoogle Scholar
  13. 13.
    Canoso RT. Sise HS. Chlorpromazine-induced lupus anticoagulant and associated immunologic abnormalities. Am J Hematol 1982; 13: 121–129.PubMedCrossRefGoogle Scholar
  14. 14.
    Harris EN, Chan JKH, Asherson RA, Aber VR, Gharavi AE, Hughes GRV. Thrombosis, recurrent fetal loss and thrombocytopenia Predictive value of the anti-cardiolipin test. Arch Intern Med 1986; 146: 2153–2156PubMedCrossRefGoogle Scholar
  15. 15.
    Harris EN, Gharavi AE, Patel S, Hughes GRV. Evaluation of the anti-cardiolipin antibody test: report of an international workshop held April 4 1986. Clin Exp Immunol 1987; 68: 215–222.PubMedGoogle Scholar
  16. 16.
    Harris EN. The second international anticardiolipin standardization workshop/the Kingston Antiphospholipid Antibody study (KAPS) group. Am J Clin Pathol. 1990; 94: 476–484.PubMedGoogle Scholar
  17. 17.
    Harris EN, Pierangeli SS, Birch D. Anticardiolipin wet workshop report: Vth International Symposium on Antiphospholipid Antibodies. Am J Clin Pathol 1994; 101: 616–0624.PubMedGoogle Scholar
  18. 18.
    Pierangeli SS, Stewart M, Silva LK, Harris EN. Report of an anticardiolipin wet workshop during the VIIth International Symposium on antiphospholipid antibodies. J Rheumatol 1998; 25: 156–162.PubMedGoogle Scholar
  19. 19.
    Conley CL, Hartmann RC. A hemorrhagic disorder caused by circulating anticoagulant in patients with disseminated lupus erythematosus. J Clin Invest 1952; 31: 621–622.Google Scholar
  20. 20.
    Boey MD. Colaco CB, Gharavi AE. Thrombosis in SLE: striking association with the presence of circulating “ lupus anticoagulant”. BMJ 1983; 287: 1088–1089.CrossRefGoogle Scholar
  21. 21.
    Shapiro SS. Thiagarajan P. Lupus anticoagulant. Prog Haemost Thromb 1982; 6: 263–285.Google Scholar
  22. 22.
    Harris EN, Gharavi AE, Loizou S, Derue G, Chan JKM, Patel BM et al. Crossreactivity of antiphospholipid antibodies. J Clin Lab Immunol. 1985; 16: 1–6.PubMedGoogle Scholar
  23. 23.
    Gharavi AE, Harris EN, Asherson RA, Hughes GRV Anticardiolipin antibody isotype distribution and phospholipid specificity. Ann Rheum Dis 1987; 46: 1–6.PubMedCrossRefGoogle Scholar
  24. 24.
    Gharavi AE, Harris EN, Asherson R, Hughes GRV. Antiphospholipid antibodies. Ann Rheum Dis 1987; 46: 1–8.PubMedCrossRefGoogle Scholar
  25. 25.
    Rote NS, Dostal-Johnson D, Branch DW. Antiphospholipid antibodies and recurrent pregnancy loss: correlation between the activated partial thromboplastin time and antibodies against phosphatidylserine and cardiolipin. Am J Obstet Gynecol 1990; 163: 575–584.PubMedGoogle Scholar
  26. 26.
    Harris EN. Pierangeli SS. A more specific ELISA assay for the detection of antiphospholipid antibodies. Clin Immunol Newslet 1995; 15: 26–28.CrossRefGoogle Scholar
  27. 27.
    Matsuura E, Igarashi Y, Fujimoto M. Anticardiolipin antibodies directed not to cardiolipin but to a plasma protein cofactor. Lancet 1990; 336: 1547.CrossRefGoogle Scholar
  28. 28.
    Galli M, Comfurius P, Maassen C, Hemker HC, de Baets MH, van Breda-Vriesman PJ et al. Anticardiolipin (ACA) antibodies directed not to cardiolipin but to a plasma protein cofactor. Lancet 1990; 336: 1544–1547.CrossRefGoogle Scholar
  29. 29.
    McNeil HP, Simpson RJ, Chesterman CN, Krilis S. Anti-phospholipid antibodies are directed against a complex antigen that includes a lipid binding inhibitor of coagulation: 13 2 glycoprotein I (apolipoprotein H). Proc Natl Acad Sci USA 1990; 87: 4120–4124.PubMedCrossRefGoogle Scholar
  30. 30.
    Peaceman AH, Silver RK, MacGregor SN, Scool ML. Interlaboratory variation in antiphospholipid antibody testing. Am J Obstet Gynecol 1992; 144: 1780–1784.Google Scholar
  31. 31.
    Reber G, Arvieux J, Comby E, Degenne D, de Moerloose P, Sanmarco M et al. Multicenter evaluation of nine commercial kits for the quantitation of anticardiolipin antibodies. Thromb Haemost 1995; 73: 444–452.PubMedGoogle Scholar
  32. 32.
    Derksen RH, Hasselaar P, Blokzijl L, Gmelig Meyling FH, de Groot PG. Coagulation screen is more specific than the anticardiolipin antibody ELISA in defining a thrombotic subset of lupus patients. Ann Rheum Dis 1988; 47: 364–371.PubMedCrossRefGoogle Scholar
  33. 33.
    Walton SP, Pierangeli SS, Campbell A, Klein E, Burchitt B, Harris EN. Demonstration of antiphospholipid antibodies heterogeneity by phospholiphid column chromatography and salt gradient elution. Lupus 1995; 4: 26.CrossRefGoogle Scholar
  34. 34.
    Matsuura E. Igarashi Y, Yasuda Triplett DA, Koike T. Anticardiolipin antibodies recognize 132 glycoprotein 1 structure altered by interacting with an oxygen modified solid phase surface. J Exp Med 1994; 179: 457–462.PubMedCrossRefGoogle Scholar
  35. 35.
    Forastiero RR, Martinuzzo ME, Kordich LC, Carreras LO. Reactivity to ßZ glycoprotein I clearly differentiates anticardiolipin antibodies from antiphospholipid syndrome and syphilis. Thromb Haemost 1996; 75: 717–720.PubMedGoogle Scholar
  36. 36.
    Roubey RAS, Eisenberg RA, Harper MF, Winfield JB. “Anticardiolipin” antibodies recognize 132glycoprotein 1 in the absence of phospholipid. J Immunol 1995; 154: 954–960.PubMedGoogle Scholar
  37. 37.
    Harris EN, Pierangeli SS, Gharavi AE. Diagnosis of the antiphospholipid syndrome: A proposal for use of laboratory tests. Lupus 1998; 7: 5144–5148.CrossRefGoogle Scholar
  38. 38.
    Balestrieri G, Tincani A, Spatola L, Allegri F, Prati E, Cattaneo R et al. Anti-132 glycoprotein I antibodies: a marker of antiphospholipid syndrome? Lupus 1995; 4: 122–130.PubMedCrossRefGoogle Scholar
  39. 39.
    Day HM, Thiagarajan P, Ahn C, Reveille JD, Tinker KF, Arnett FC. Autoantibodies to ß2 glycoprotein I in systemic lupus erythematosus and primary antiphospholipid sybndrome: clinical correlations in comparison with other antiphospholipid antibody tests. J Rheumatol 1998; 4: 667–674.Google Scholar
  40. 40.
    Merkel PA, Chang Y, Pierangeli SS, Harris EN, Polisson RP. Comparison between the standard anticardiolipin antibody test and a new phospholipid test in patiens with a variety of connective tissue diseases. J Rheumatol 1999; 26: 591–596.PubMedGoogle Scholar
  41. 41.
    Pengo V, Biasiolo A, Fior MG. Autoimmune antiphosphoilipid antibodies are directed against a cryptic epitope expressed when the /32 glycoprotein I is bound to suitable surface. Thromb Haemost 1995; 89: 397–402.Google Scholar
  42. 42.
    Abreu I, Pierangeli SS, Harris EN. Comparison of three assays for the detection of antiphospholipid and anti-132 glycoprotein I antibodies. Lupus 1998; 7: S211.CrossRefGoogle Scholar
  43. 43.
    Guerin J, Feighery C, Sim RB, Jackson J. Antibodies to 02 glycoprotein I, a specific marker for the antiphospholipid syndrome. Clin Exp Immunol 1997; 109: 304–309.PubMedCrossRefGoogle Scholar
  44. 44.
    Bevers E, Galli M, Barbui T, Comfurius P, Zwaal RF. Lupus anticoagulant IgG’s (LA) are not directed to phospholipids only, but to a complex of lipid-bound human prothrombin. Thromb Haemost 1991; 66: 629–632.PubMedGoogle Scholar
  45. 45.
    Rao LVM, Hoang AD, Rapaport SI. Differences in interactions of lupus anticoagulant IgG with human prothrombin and bovine prothrombin. Thromb Haemost. 1995; 73: 668–674.PubMedGoogle Scholar
  46. 46.
    Oosting JD, Derksen RH, Bobbink IW, Hackeng JM, Bouma BN, deGroot PC. Antiphospholipid antibodies directed against a combination of phospholipids with prothrombin, protein C or protein S: an explanation for their pathogenic mechanism? Blood. 1993; 81: 2618–2625.PubMedGoogle Scholar
  47. 47.
    Matsuuda J, Saitoh N, Gohchi K, Gotoh M, Tuskamoto M. Anti-annexin V antibody in systemic lupus erythematosus patients with lupus anticoagulant and/or anticardiolipin antibody. Am J Hematol 1994; 47: 56–58.CrossRefGoogle Scholar
  48. 48.
    Stewart MW, Gordon PA, Etches WS, Marusyk H, Poppema S, Bigam. Binding of cardiolipin to polystyrene beads: evidence for a lamelar phase orientation. Br J Haematol 1995; 90: 900–905.PubMedCrossRefGoogle Scholar
  49. 49.
    Wilson W. International consensus statement on preliminary classification criteria for definite antiphospholipid syndrome: report of an international workshop. Arthritis Rheum 1999; 42: 1309–1311.PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag London 2000

Authors and Affiliations

  • S. S. Pierangeli
  • A. E. Gharavi
  • E. N. Harris

There are no affiliations available

Personalised recommendations